Clinical Programmer jobs in Santa Barbara, CA

The position is responsible for driving the development and design of CenCal Health Health’s EDI and operational data. Responsibilities include, but are not limited to:

• Maintain and develop Health Insurance Portability and Accountability Act (HIPAA) transactions.
• Design and development of solutions related EDI processes.
• Collaborate with other CenCal Health departments to assess and prioritize needs, and assist with developing strategies, plans, policies and procedures related to providing effective EDI solutions.
• Discover, explore, analyze and document data from all source and target systems to better understand the total scope of data availability at CenCal Health
• Recommend and execute modifications to EDI mappings and workflow in order to improve efficiency, reliability, and performance.
•  Determines needs and capabilities of external customers to submit data electronically proactively identifies potential problems and defines user requirements, custom mappings, and user authorization protocols 
•  Promotes and further efforts to increase CenCal Health data quality and integrity; to ensure the quality and integrity of CenCal Health reporting through the implementation of standards based measures as defined by CenCal Health staff.
• Reviews existing EDI processes, procedures and systems to improve submission rate, reduce paper remits and improve the quality of each encounter with EDI Identifies best practices.
• Determines database structural requirements by analyzing client operations, applications, and programming, reviewing objectives with clients.
•  Provides analysis, support and guidance to both internal and external critical customers on complex electronic data transfers covering enrollment, claims, billing statements and payments 
• Initiates, communicates and coordinates all EDI activities with trading partners
• Recommending technical and procedural design for new or revised applications including flow charts
• Meets with CenCal Health customers and technical staff to determine information needs and requirement
• Implemented different types of Replication Models like Snapshot and Transactional.